DIABETES WATCH

Kids with Diabetes:
Ketoacidosis Common at Diagnosis

Diabetic ketoacidosis, which makes
the blood more acidic than normal, is a
potentially life-threatening condition at
the time of a diabetes diagnosis for nearly
30% of children with type 1 diabetes
and 10% of those with type 2 diabetes.

The Search for Diabetes in Youth
Study included 3666 patients who were
diagnosed with diabetes before age 20
in US study areas from 2002 to 2004.
The researchers conducted a medical
review for 2824 of the patients to determine
the presence of ketoacidosis.

The findings, reported in Pediatrics
(May 2008), indicate that overall 25.5%
of the patients had the condition when
diagnosed with diabetes. As the participants
got older, the proportion
decreased, ranging from 37.3% in children
younger than 5 years to 14.7% in
15- to 19-year olds.

Furthermore, about half of the participants
were hospitalized at diagnosis.
The percentage of patients hospitalized
with ketoacidosis was 93%,
compared with 41% of patients without
the condition.

Campaign Targets
Type 2 Diabetes

The National Diabetes Goal initiative seeks to encourage
prevention and ensure that, by 2015, 45% of Americans who
are at risk for type 2 diabetes will know their blood glucose
level and how to manage the disease. For individuals who
have blood glucose levels in the prediabetes range, lowering
blood glucose levels can help prevent or delay the onset of
the disease.

The program was launched by the National Changing
Diabetes Program. The National Association of Chain Drug
Stores (NACDS) has joined the effort. ?America?s pharmacies
play a pivotal role in helping patients manage diabetes and
other chronic diseases,? said Steven C. Anderson, IOM, CAE,
NACDS president and chief executive officer.

Diabetes Drugs Top
Drug Spending Growth

Medco Health Solution Inc?s 2008 Drug Trend Report found
that spending on diabetes treatments has increased 12%, surpassing
cholesterol drug spending. The increase is attributed to
a shift toward higher-cost treatments, brand name drug price
inflation, and moderate growth in the number of patients getting
treatment.

Although use of diabetes medications increased only 2.3%
during 2007, the cost of diabetes treatments rose sharply as
patients moved to new drugs.

The newly available treatments have advantages over older
drugs because they are faster-acting and can help patients
maintain consistent blood sugar levels to prevent complications
from the disease.

Quality of Life Impacts Lifespan

Quality of life is a factor in longevity for patients with diabetes,
according to a study reported in Diabetes Care (May 2008).
The study included 1143 Dutch adults with type 2 diabetes.

Quality of life was associated with death risk, independent of
a range of factors in adults with the disease. Using a standard
survey on health-related quality of life completed by the participants,
the patients who scored below the median for physical
well-being were 2 times as likely to die over the next 6 years,
compared with those who scored higher.

The researchers concluded that the results should give physicians
?added incentive? to ask patients with diabetes about
their quality of life and address any problems when possible.

Do Diabetics Get Necessary BP Treatment?

A study of 1169 patients with diabetes
and high blood pressure (BP) have
only a 50?50 chance that their physicians
will change their medications
as necessary or offer other treatment
options, according to a study reported
in the Annals of Internal Medicine (May
20, 2008).

For the study, the researchers
collected data on the patients who
received care from the US Veterans
Administration during a 1-year period.
The patients were seen at 9 different
sites in 3 states. At the study onset, all
the patients had high BP (140/90 mm
Hg or higher). The BP goal for patients
with diabetes is 130/80 mm Hg. The
researchers found that 49% of the
patients had their BP medication treatment
changed during a clinic visit. This
meant that the patients received either
a new medication, a change in dose of
current medication, or a plan to follow
up within a month.